Jennifer L. Kilgo, Jerry Aldridge, Betty Denton, Laura Vogtel,
Janice Vincent, Cathy Burke, and Rachel Unanue, University of Alabama at Birmingham
Published in Focus on Inclusive Education, Fall 2003, Vol. 1, # 1
Early childhood special education is a rapidly growing and ever-changing field. According to the U.S. Department of Education (2003), more than two million young children with disabilities are served by early childhood special education programs throughout the United States each year. Early childhood special education (birth through age 8) includes early intervention, preschool special education, and early primary-grade special education. The children receiving these services are diverse in terms of their ages; socio-economic, cultural, linguistic, ethnic, and religious backgrounds; and disabilities. Children with special needs may have physical, behavioral, cognitive, language, or learning disabilities, and they usually qualify for early intervention, early childhood special education, and related services provided for under the Individuals With Disabilities Education Act (IDEA).
Just as the field of early childhood special education has grown in terms of the number and diversity of children and families served, recommended practices have evolved to meet the changing needs of the field. Appropriate practices have become more clearly defined in terms of what represents recommended practice, how services should be delivered, and how personnel should be prepared (Sandall, McLean, & Smith, 2000).
Recommended practice in early childhood special education emphasizes that young children with disabilities should be included in natural learning environments—places where and activities in which children without disabilities of the same age and their families would participate. Although much discussion over the years has focused on the benefits and challenges of inclusive early childhood programs (Bredekamp, 1993; Buysse & Bailey, 1993; Fox & Hanline, 1993; McLean & Odom, 1993; Miller, 1992; Peterson & Beloin, 1998), an inclusive setting is no longer a rarity. Legislation such as IDEA has provided continued support of inclusive educational programs for young children with disabilities.
Effective teamwork is essential for successful provision of early childhood special education services in inclusive settings (Sandall, McLean, & Smith, 2000). Calls for transdisciplinary services are commonplace. Furthermore, it is recommended that a team-based orientation permeate all aspects of service delivery, to include assessment, team meetings and program planning, related services, intervention activities, and service coordination (Miller & Stayton, 2000).
Transdisciplinary Team-based Services
It has long been recognized that early childhood special education involves collective responsibility; teamwork is needed to provide exemplary services to young children with special needs and their families (Allen, Holm, & Schieflebusch, 1978; Bruder, 1996; Campbell, 1987; McWilliam, 2000). Different perspectives lead to better decision-making; no one discipline can provide everything that a child and family needs. The effective team includes early childhood special educator, general early childhood educator, physical therapist, occupational therapist, speech-language pathologist, nurse, and paraeducator (depending on the needs of the child). In addition, the team includes the parents themselves (or guardians), who are central members of the transdisciplinary team.
Through transdisciplinary service delivery, professionals from different disciplines work together, with one of them serving as the primary contact with the family. The primary contact uses strategies that the other team members provide; the other team members have direct contact with the child and family only as necessary (e.g., for assessment, demonstration, progress reporting). Traditional medical-model practices, in which different team members perform largely independently, are antithetical to recommended practices in early childhood special education (McWilliam, 2000). The transdisciplinary approach is recommended because it: 1) prevents the fragmentation of services along disciplinary lines, 2) avoids duplication of services, 3) views the whole child's development as integrated, and 4) emphasizes the importance of the family as equal, contributing members of the team (Losardo & Notari-Sylverson, 2001; McWilliam, 2000).
A critical component of effective transdisciplinary teams is continuous communication among all team members. Ongoing communication is essential for maintaining a consistent approach to meeting the changing needs of the child, who is always considered within the context of the family. As one mother described, "The therapists and teachers must remember that the child is part of an entire family. If children are viewed in isolation and the team doesn't understand what the rest of the child's life is like and what's going on with the family, there's no way the process will work. And the only way they will know what's really going on is through communication with the parents."
In addition, effective transdisciplinary teams rely on the collaboration of all team members. Professionals from different disciplines, alongside the family, share roles and responsibilities and purposely cross discipline boundaries when they assess, plan, provide intervention, and monitor progress. All participants learn from one another and work together to accomplish the goals of each child and family. This, of course, means that team members must be willing to share their knowledge with each other and be open to acquiring new skills (McWilliam, 2000). Each professional must develop skills in problem solving, conflict resolution, and team consensus-building.
This type of teamwork from educators, therapists, paraeducators, and families makes inclusion and integrated therapy possible. Related services are provided to the child within the routines and activities of the natural setting (Davis, Kilgo, & Gamel-McCormick, 1998; Sandall, McLean, & Smith, 2000). For example, during snack time in an inclusive preschool classroom, the speech-language pathologist can work with a child on his or her communication goals, such as verbalizing or signing a request for juice and other snack items, as well as on social exchanges with peers. The physical therapist can provide input on the child's ambulation to the table where the snack will be served, and the occupational therapist may provide recommendations for proper positioning of the child while eating. In this way, the child is not pulled out of the classroom for isolated therapy and can participate in the regular routines. The teacher can implement the therapists' suggestions during the everyday activities of the early childhood program, and parents and other caregivers can do the same at home or in the community. Integrated therapeutic activities can provide the child with many opportunities to practice and generalize new skills in natural settings where they will be needed.
Transdisciplinary Personnel Preparation
Although the momentum of the past decade has led to the availability of inclusive educational environments for young children, these programs often have been staffed by teachers and therapists prepared in traditional discipline-specific programs. Many colleges and universities across the nation are responding to the changes in early childhood environments by redesigning their personnel preparation programs to reflect transdisciplinary team-based practices (Kilgo & Bruder, 1997; Miller & Stayton, 2000; Stayton, Miller, & Dinnebeil, 2002).
Faculty members representing multiple disciplines and departments at the University of Alabama at Birmingham (UAB) worked together for over five years to design dynamic experiences to prepare graduate students for transdisciplinary service delivery. In 1999, UAB received a grant, titled Project TransTeam, from the U.S. Department of Education to develop a masters-level preservice preparation program to increase the quantity, quality, and diversity of personnel who provide services to young children with disabilities and their families. Students from early childhood special education, general early childhood, physical therapy, occupational therapy, and nursing gain transdisciplinary team experience through seminars and field experiences. Students and faculty members work together, share expertise, and collaborate to serve young children with low-incidence disabilities and their families. (See Table 1 for the benefits of transdisciplinary personnel preparation.)
The program at UAB is based on the belief that young children with disabilities and their families require teams of professionals from diverse backgrounds who are well-prepared with skills in transdisciplinary teamwork, collaboration, family-centered and culturally sensitive approaches, instructional and assistive technology, and effective strategies for promoting inclusion. Seminars have been designed to present "real world" situations and challenges faced by professionals as they attempt to deliver transdisciplinary services in inclusive settings. Some of the issues and challenges addressed through team-based processes and strategies include: How do professionals from various disciplines implement developmentally appropriate practice (DAP) when not all disciplines represented on the team are familiar with DAP? How can integrated therapy be provided when the general education teachers do not want therapists interfering with their classrooms? What do you do when team members advocate for practices that are in conflict with the family's cultural values?
The various components of Project TransTeam can be seen in Figure 1. In addition to the collaborative efforts of faculty and students representing various departments and schools at UAB, Project TransTeam involves extensive collaborative efforts with family members and professionals from local agencies (e.g., practicum sites) in rural and urban settings, state agencies (e.g., lead agencies for Part C and Part B-619), and other colleges, universities, and agencies involved in personnel preparation throughout the state. Particular emphasis is placed on disseminating information about the program to local, state, and national constituents.
As personnel preparation programs across the nation continue to realign their programs to meet the needs of diverse inclusive educational settings, it becomes increasingly important to move towards transdisciplinary personnel preparation programs (Kilgo & Bruder, 1997; Stayton, Miller, & Dinnebeil, 2002). Just as inclusive early childhood environments are the settings of choice to educate young children with disabilities, team-based personnel preparation is the model of choice to produce professionals who are well-qualified to meet the challenges of the 21st century.
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